Non-adherence to drugs by patients poses challenge in TB control

Despite government efforts to eradicate tuberculosis (TB), India still has the highest global burden of TB cases and the disease continues to be a major public health problem.TNN | March 25, 2016, 07:41 IST

Visakhapatnam: Despite government efforts to eradicate tuberculosis (TB), India still has the highest global burden of TB cases and the disease continues to be a major public health problem. Statistics provided by the World Health Organisation (WHO) reveal an estimated incidence figure of 2.2 million cases of TB in India out of a global incidence of nine million.

It is estimated that around 40 per cent of the Indian population is infected with TB bacteria, most of whom have latent rather than active TB. The United Nation's goal is to end TB by 2030 by joining hands with all stakeholders. In India, failure to achieve goals are mainly due to illiteracy and complacency. Once the symptoms such as fever, cough and haemoptysis are controlled, patients stop medicines without completing the full course, point out medical experts.

Dr P Sambasiva Rao, medical superintendent at the Government Hospital for Chest and Infectious Diseases, averred, "The patient needs to take medicines for six months continuously in case of normal TB and for 24 months in case of multi-drug resistant (MDR) TB without skipping a single day. Patients and their family members need to realise that unless they strictly adhere to drugs, TB cure and control would be unsuccessful and this is mainly the reason for TB continuing to be a public health issue even today. Health workers should also supervise and ensure that patients complete the TB medicine course.

In Visakhapatnam, Child Foundation of India, Dr Kutikuppala Surya Rao Hospitals in collaboration with Acharya Kutikuppala Surya Rao Charitable Trust are working towards controling TB/HIV epidemic. Studies reveal that 25 per cent of deaths among HIV positive people are due to TB and HIV positive patients are 25-31 times more prone to the disease. Under this scenario, a door-to-door survey was recently conducted in the first phase across 200 families in Indira Nagar colony near Gopalapatnam to identify those who are suffering from cough, sputum and evening rise in temperature for more than two weeks. The socio-economically backward colony has 1,500 to 1,800 families residing mostly in asbestos roof houses. The nearest health centre is the community health centre at Gopalapatnam, less than one kilometre away.

"The objective of the survey was to bring continuous awareness on TB for early diagnosis, prevention and cure among slum dwellers, to highlight the grave association between HIV and TB, to bring down the incidence of morbidity and mortality, to collaborate with national and international medical agencies and civil societies and NGOs on HIV/TB and to prevent multi-drug resistant TB," averred Dr Kuikuppala Surya Rao.

As per the survey, a total number of 750 individuals were interviewed of which 352 were male and 398 were female respondents. Out of the total male population covered (352), 147 respondents were between the age group of 15-40, while 205 were 41 years and above. Among the 392 female respondents interviewed, 182 were aged between 15-40 years, while the remaining 210 were above 41 years of age. A total of 15 respondents have reported weight loss over the past few months while 21 respondents have experienced chest pain. Six respondents have reported coughing of blood while at least 12 have reported phlegm during cough.

"A total number of 23 out of 750 respondents (3.06 per cent) have reported to have tested positive for HIV and ART (antiretroviral) treatment and counselling support is being extended to them. Among these, 16 were male and seven were female individuals. 31 out of 750 (4.1%) tested positive for TB," informed Dr Surya Rao.

Meanwhile, on the occasion of world TB Day on Thursday, the district medical and health (DMHO) office organised an awareness campaign on Beach Road, followed by a rally from the Collectorate to the Zilla Parishad followed by a meeting at the Zilla Parishad Hall. The Government Hospital for Chest and Infectious Diseases conducted a continuous medical education (CME) programme and discussed about the past, present and future trend of TB in India and in the world.

With immense pride “India Live” celebrated its 10th national conference in Mumbai from 28th February to 3rd March 2019. The conference turned out to be a gold mine of information, with emphasis on academics, education and exchange of knowledge with leaders in interventional cardiology from both India and abroad.